The present invention pertains to gynecological tenaculums used for gripping the human female uterine cervix to press the cervix about a medical instrument such as a hysteroscope to prevent the reflux of distension media from the uterus.
Hysteroscopy involves one type of examination of the human uterus. The elongated hysteroscope is used with a surrounding sheath which can have various shapes. The sheath and hysteroscope are inserted through the uterine cervix into the uterus. The space between the sheath and the hysteroscope serves as a conduit for the ingress of a distension medium. The distension medium such as carbon dioxide, a saline solution, Dextran (trademark) 70 liquid solution or Hyskon (trademark) liquid solution, inflates the uterus to permit viewing of the uterine interior for disease, trauma or other problems.
When the uterus is filled with the distension medium, the natural tensile force of the uterine wall can reflux the medium around the sheath's exterior back through the cervix. Refluxing is undesirable in most instances because the uterus must remain inflated for proper examination.
In some instances it is desirable to discharge controlled amounts of distension medium through the cervix to contract the uterus for better examination.
Heretofore, a tenaculum with two pivotally mounted arms having inwardly directed spikes has been used in hysteroscopic examination. The two spikes are placed against the cervix to press it against the sheath. The gripping action is performed solely by the spikes digging into the flesh, and the lack of impedance of such digging causes bleeding, trauma and pain for the patient. It is sometimes necessary to use two of these tenacula, which creates awkwardness and hinders mobility.
Other prior devices have used enlarged tubular members, tubes with enlarged suction sections, and balloons to control refluxing. However these devices do not provide the advantages of the present invention.
The present invention provides advantages over the prior art. The inventive gynecological tenaculum comprises a pair of movably mounted extension members each of which branches into two arms. Each arm has a tooth at its end, and an enlarged section adjacent the tooth.
When a medical instrument such as a hysteroscope and its sheath are inserted through the cervix, the new tenaculum can be conveniently operated by a single hand to cause the four teeth and enlarged sections to grip the cervix and press it against the sheath to stop, or to otherwise control, the reflux of distension media.
The tenaculum places the gripping parts at strategic points for effective pressure distribution of the cervix about the hysteroscope/sheath. The number of gripping parts reduces the pressure needed at any one point of contact to properly grip the cervix. Moreover, the gripping and sealing of the cervix is unaffected by the size and shape of the sheath or enclosure which fits about it. The enlarged sections minimize the penetration of the gripping members into the flesh to thus minimize bleeding and pain. The enlarged sections also provide a surface for engaging the cervix to thus spread the gripping force over a larger part of the tenaculum and reduce the force per square centimeter that is applied to the flesh, to minimize trauma and bleeding. The inventive effects of the enlarged sections are also appreciated with extension members having a single arm.
The inventive tenaculum can be easily and conveniently cleaned and is extremely sanitary. Additionally, it is not necessary to replace parts, such as seals, with the present invention. These features and others are more fully explained in the detailed description that follows.